Peripheral Artery Disease

Peripheral artery disease refers to all artery diseases other than the heart and brain. In short, it is a disease that occurs when the arteries that provide blood flow to the arms, legs and internal organs are completely or partially blocked due to atherosclerosis (hardening of the arteries).

Atherosclerosis causes peripheral vascular disease in two ways:

1. While there should be a rapid increase in the amount of blood and oxygen sent to the tissues in moments when the need for oxygen increases, such as during exercise, atherosclerosis does not allow this increase due to the narrowing in the vessels and symptoms of the disease appear.
2. Occlusion of an artery (artery) due to thrombus or embolism (blood clots) causes sudden lack of oxygen and malnutrition in the tissue.

Chest pain that occurs during exercise or intermittent leg pain that occurs with walking (intermittent claudication) are examples of situations where the increased oxygen and blood needs of the tissue cannot be met. In addition, stroke and heart attack are examples of sudden oxygen deficiency and malnutrition in the tissues as a result of complete blockage of the arteries with blood clots.

In rare cases, peripheral vascular disease As a result, open wounds, ulcers, gangrene or some other damage that are very difficult to heal may occur as a result of the decrease in blood flow to the arms or especially the legs. These areas do not receive enough blood and are very prone to infection. In advanced cases, amputation (cutting out gangrenous tissue) may be necessary.

% 5 of adults over 50 years of age have peripheral vascular disease. Peripheral vascular disease is more common in men than in women. Known risk factors for peripheral vascular disease are the same as the causes of atherosclerosis (hardening of the arteries). These risk factors are:

• High levels of LDL cholesterol (bad cholesterol) and triglycerides in the blood
• Low levels of HDL cholesterol (good cholesterol) in the blood
• smoking
• Diabetes mellitus
• High blood pressure (hypertension) or a family history of hypertension
• Family history of atherosclerosis (hardening of the arteries)
• chronic kidney failure
• Overweight or obesity

The risk increases even more when risk factors for peripheral vascular disease occur together. An individual with two risk factors is at greater risk than an individual with a single risk factor.

The most common symptoms are intermittent leg pain that occurs with walking (intermittent claudication) and, in advanced cases, leg pain at rest. The location and severity of the pain varies depending on the location of the vessel in which the blockage occurs and the degree of the blockage. The most common place for intermittent claudication is where the calf muscles are located (the muscles in the back of the leg below the knee). This pain in the calf muscles only occurs during exercise such as walking or running, and the pain gradually increases as walking or exercise continues. Eventually, the patient becomes unable to withstand this increasing pain and is forced to stop. Then, with rest, the pain disappears quickly. Intermittent claudication may affect one or both legs.

It occurs when vascular occlusion is very advanced and sufficient blood and oxygen cannot be delivered to the legs even at rest. The pain typically affects the feet and is usually severe. This pain increases especially at night when the patient lies on his back.

• Numbness in legs,
• Weakness and atrophy (decrease in diameter and strength) in the calf muscles
• Feeling cold and cold in the legs and feet,
• Color change in the feet (pale when lifted into the air and dark red when lowered)
• Hair on the back of the feet begins to fall out and toenails thicken
• In advanced cases of serious vascular occlusion, painful open wounds (ulcers) may occur or gangrene may occur in the feet and legs, especially starting from the toes.

Peripheral Artery Disease Treatment:

Quitting smoking and dieting help reduce cholesterol and other fat levels in the blood and keep blood pressure under control.

Keeping diabetes under control, regular exercise.

Exercise both helps the muscles use oxygen more effectively and accelerates the development of collateral circulation (a new vascular network consisting of small arterial branches developed beyond the obstruction).

Blood thinning drugs (e.g. aspirin and clopidogrel), Cholesterol lowering drugs (statins)

Surgical treatment (Peripheral Bypass)

Among the surgical treatment methods used for the treatment of peripheral vascular disease: peripheral bypass procedures and endarterectomy. Nowadays, these can be performed even at levels down to the ankle with minimally invasive procedures. Lesions that cause obstruction in the vessel, vessels containing more than one stenosis, or long-segmented severe stenosis are conditions that require surgical treatment. Bypass surgery is the provision of blood flow through a side pathway created from before to after the blocked area with a vein or a synthetic vein (known as a graft) taken from your body. In the endarterectomy procedure, the plaque layer that causes obstruction in the veins going to the arms or legs is removed.